Workers Compensation - Claims Associate | Riverside, CA or Ontario, CA (On-Site)

Sedgwick; Riverside (CA); On-site; USD 71,635,000 - 80,231,000; Full time

Benefits offered by this job

Flexible work schedule

Referral incentive program

Career development and promotional成长 〉

Job summary

Sedgwick in Riverside, CA is seeking a Workers' Compensation - Claims Associate to analyze low level claims and adjudicate benefits under company standards. This on-site role offers opportunities for professional growth within a global leader.

We require a high school diploma or GED and at least one year of general office experience; knowledge of claims handling is a plus. Enjoy a comprehensive benefits package and a supportive, inclusive team culture.

Qualifications

• High school diploma or GED required.
• One year of general office experience preferred.
• Claims knowledge or experience is a plus.

Responsibilities

• Analyze low level workers' compensation claims to determine benefits due.
• Adjudicate claims and communicate actions with clients and claimants.
• Support senior staff with larger or more complex claims.
• Maintain accurate claim documentation and coding.

Education

High school diploma or GED

Job description

By joining Sedgwick, you'll be part of something truly meaningful. It’s what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there’s no limit to what you can achieve.

Newsweek Recognizes Sedgwick as America’s Greatest Workplaces National Top Companies

Certified as a Great Place to Work®

Fortune Best Workplaces in Financial Services & Insurance

Workers Compensation - Claims Associate | Riverside, CA or Ontario, CA (On-Site)

Are you looking for an opportunity to join a global industry leader where you can bring your big ideas to help solve problems for some of the world’s best brands?

• Apply your knowledge and experience to adjudicate complex customer claims in the context of an energetic culture.
• Deliver innovative customer-facing solutions to clients who represent virtually every industry and comprise some of the world’s most respected organizations.
• Be a part of a rapidly growing, industry-leading global company known for its excellence and customer service.
• Leverage Sedgwick’s broad, global network of experts to both learn from and to share your insights.
• Take advantage of a variety of professional development opportunities that help you perform your best work and grow your career.
• Enjoy flexibility and autonomy in your daily work, your location, and your career path.
• Access diverse and comprehensive benefits to take care of your mental, physical, financial and professional needs.

ARE YOU AN IDEAL CANDIDATE?

We are looking for driven individuals that embody our core values that include empathy, accountability, collaboration, growth, and inclusion.

LOCATION:

In-Office Ontario, California or Riverside, California

PRIMARY PURPOSE:

To analyze low level workers compensation claims to determine benefits due; to ensure ongoing adjudication of claims within company standards and industry best practices

ESSENTIAL FUNCTIONS And RESPONSIBILITIES

• Adjusts medical-only claims and minor lost-time workers compensation claims under close supervision.
• Supports other claims representatives, examiners and leads with larger or more complex claims as necessary.
• Processes workers compensation claims determining compensability and benefits due; monitors reserve accuracy, and files necessary documentation with state agency.
• Communicates claim action/processing with claimant, client and appropriate medical contact.
• Ensures claim files are properly documented and claims coding is correct.
• May process routine payments and prescriptions and status reports for lifetime medical claims and/or defined period medical claims.
• Maintains professional client relationships.

ADDITIONAL FUNCTIONS And RESPONSIBILITIES

• Performs other duties as assigned.
• Supports the organization's quality program(s).
• Travels as required.

Qualifications

Education & Licensing

High school diploma or GED; Licenses as required

Experience

One (1) year of general office experience or equivalent combination of education and experience required. Claims industry experience preferred.

TAKING CARE OF YOU

• Flexible work schedule.
• Referral incentive program.
• Career development and promotional growth opportunities.
• A diverse and comprehensive benefits offering including medical, dental vision, 401K on day one.

Work Environment Requirements Include

When applicable and appropriate, consideration will be given to reasonable accommodations.

Mental:

Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines

Physical:

Computer keyboarding

Auditory/Visual:

Hearing, vision and talking

As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is $25-28/hr. A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits.

Qualified applicants with arrest or conviction records will be considered for employment in accordance with the Los Angeles County Fair Chance Ordinance for Employers, the City of Los Angeles’ Fair Chance Initiative for Hiring Ordinance, the San Diego Fair Chance Ordinance, the San Francisco Fair Chance Ordinance, the California Fair Chance Act, and all other applicable laws.

Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.

If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.